Saving Troubled Minds

Whenever Patient A is close to a sharp object, he has violent mental flashes. He is afraid he will get cancer by touching certain objects, so he compulsively washes his hands. He hears loud buzzing noises, which he silences by pressing his flattened palms hard against his ears. Sometimes, crosswalk lines look incorrectly drawn, so he'll walk outside the lines as a form of protest. He used to do well in school, but now in the 10th grade, he's failing all his classes. His mother is beside herself with worry.

Patient A isn't real, but he might as well be. He's a composite of young people who seek treatment at UCLA, where researchers and clinicians are breaking new ground in the battle against schizophrenia. The war is being fought on two fronts: the clinic, where mental health professionals are helping teens like Patient A learn to cope in a world turned cruel and chaotic, and the lab, where researchers are examining molecular changes in the brains of young people at high risk for schizophrenia.

If this lab research goes well — and there are early indications at UCLA and elsewhere that it will — a 12-year-old who is sliding toward psychosis may be able to take drugs or undergo gene therapy to significantly alter the course of the disease or perhaps forestall it entirely.

"That's many years off, but what we have accomplished already gives us some clues that make it sound not so science fictiony," says Tyrone D. Cannon, lead researcher in the effort and director of UCLA's Staglin Family Music Festival Center for the Assessment and Prevention of Prodromal States, or CAPPS. The first part of the center's name comes from the Northern California family of winemaker-venture capitalists and the music festival they host each year to raise money for research into schizophrenia and other serious mental disorders.

Schizophrenia is shockingly prevalent. One out of 100 people will develop the disease at some point in life, usually between the ages of 16 and 25. Many live with family members or in assisted living centers; others bounce from the streets to jail to psychiatric wards. Side effects of antipsychotic drugs available today — lethargy, weight gain, muscle stiffness and a deadening of facial expressions — add insult to injury. Fully three-quarters of patients fall off their medications. Many sufferers never get drugs at all.

Most people with schizophrenia are diagnosed after a psychotic episode, when the disease is full blown and harder to treat. At this point, explains Cannon, patients have an unshakeable conviction in the reality of their delusions and hallucinations. Appeals to reason are futile.

So researchers in recent years have turned their attention to younger people with early-onset symptoms that precede the transformative psychotic episode. (Fifty percent of these patients will go on to develop full-blown schizophrenia.)